Johanson J F, Sonnenberg A
Division of Gastroenterology, Medical College of Wisconsin, Milwaukee.
Am J Gastroenterol. 1994 Nov;89(11):1981-6.
Constipation is widely believed to cause hemorrhoids. However, recent evidence questions the importance of constipation in the development of this common disorder. In the present study, the association of hemorrhoids with constipation and other potential risk factors was examined.
The analysis consisted of 325 consecutive patients who underwent proctoscopy at the Milwaukee VA Medical Center during 1989. Each participant was questioned regarding hemorrhoid symptoms, bowel habits, and associated medical conditions. At the time of proctoscopy, the presence or absence of hemorrhoids was recorded.
Hemorrhoids were identified in 168 subjects; the remaining 157 served as controls. No significant association was observed between constipation and hemorrhoids. Increasing age, cirrhosis, and varicose veins likewise were not associated with hemorrhoids. In contrast, the subjective complaint of diarrhea [odds ratio 2.1; 95% confidence limits (CL) 1.2-3.7] and obesity (odds ratio 1.7; 95% CL 1.1-2.7) were significantly associated with the presence of hemorrhoids.
The results of this analysis suggest that diarrhea but not constipation may represent a risk factor for the development of hemorrhoids.
人们普遍认为便秘会导致痔疮。然而，最近的证据对便秘在这种常见疾病发展中的重要性提出了质疑。在本研究中，研究了痔疮与便秘及其他潜在危险因素之间的关联。
分析包括1989年在密尔沃基退伍军人事务医疗中心接受直肠镜检查的325例连续患者。对每位参与者询问痔疮症状、排便习惯及相关医疗状况。在直肠镜检查时，记录是否存在痔疮。
168名受试者被诊断患有痔疮；其余157名作为对照。未观察到便秘与痔疮之间存在显著关联。年龄增长、肝硬化和静脉曲张同样与痔疮无关。相比之下，腹泻的主观主诉[比值比2.1；95%置信区间（CL）1.2 - 3.7]和肥胖（比值比1.7；95% CL 1.1 - 2.7）与痔疮的存在显著相关。
该分析结果表明，腹泻而非便秘可能是痔疮发生的一个危险因素。
